Gauging Progress toward a Healthier IU: Focus on IU Southeast · A total of 146 IUSE employees responded to our survey, yielding a 32.7% response rate. Quantitative data were analyzed

Revised 5.10.2016 1 IUSE

Gauging Progress toward a Healthier IU: Focus on IU Southeast A Comparison of the IU Workplace Health and Wellness Survey Results from 2013 and 2015

1 INTRODUCTION

In 2013, Indiana University implemented the first university-wide survey of employee health and wellness. In support of building a culture of health and

wellness across all campus locations, the aims of the IU Workplace Health & Wellness Survey were to:

1) establish baseline measures of workplace health to gauge the impact of the Healthy IU initiative over time;

2) understand how well IU workplaces are supporting the health of employees;

3) identify health advantages and challenges of this university community;

4) identify opportunities for change that are actionable from an organizational standpoint.

In 2015, the survey was repeated. This report focuses on the first aim, as we systematically compare 2013 survey results for IU Southeast with 2015

results to assess our progress toward a healthier IU.

2 METHODS

2.1 SURVEY CONTENT The wording of most questions in the 2015 survey remained consistent with 2013 wording, enabling valid year-to-year comparisons. Some questions

were modified, deleted, or added to improve the value of information for organizational planning. Please note in the tables that follow, “NA” identifies

questions that were Not Asked or Not Asked in a comparable way in both years.

The survey’s main content areas are shown on the diagram below along a continuum of change. Moving from left to right along the continuum, the

difficulty and time required for change increases. Areas further to the left represent the greatest potential for rapid change when organizational

interventions are implemented; right-most areas are anticipated to take far longer to reflect change. We will consider the changes observed at IUSE

between 2013 and 2015 in the context of this continuum.


2.2 COMPARATIVE ANALYSIS & INTERPRETATION

A total of 146 IUSE employees responded to our survey, yielding a 32.7% response rate. Quantitative data were analyzed using IBM SPSS Statistics 23.0

(IBM Corp., 2015). For valid comparison, survey data for both survey years (2013 and 2015) were weighted to the 2013 employee population using two

weighting variables: sex (female or male) and job type (faculty or staff). Respondent demographics compared to the employee population overall are

shown in the table below. There is consistency in the demographic characteristics of respondents in 2015 compared to 2013. In both years, there were

proportionally more females than males. The weighting process compensates for such differences.

2013 2015

Demographics Respondents Full-Time Employees* Respondents Full-Time Employees

Sex

Female 67% 56% 66% 55%

Male 33% 44% 34% 45%

Job Type

Staff 61% 69% 68% 69%

Faculty 39% 31% 32% 31%

*2013 Full-Time Employee proportions have been corrected since originally reported

Organizational Support

Resources & Programs

Lifestyle

Preventive Health Care

Stress

Health & Illness


For each question being compared, we calculated and considered two measures of change, described and explained in the table below: 1) absolute

change, and 2) relative change. Further, we considered both the statistical and practical significance of these changes in the rates. Chi-square testing

was conducted to assess whether the absolute difference in rates was statistically significant. However, given the large number of respondents to our

survey (4,314), differences may be statistically significant though not practically meaningful, so criteria were set for both statistical and practical

significance. The benchmark set for practical significance was >10% relative change, either better or worse.

Absolute Change Relative Change

Meaning The simple difference between the

two rates being compared

Expresses the change relative to the

starting point; allows us to compare

the degree of change across factors

that vary widely in prevalence

Calculation = 2015 Rate - 2013 Rate = (2015 Rate - 2013 Rate)

2013 Rate

Example 1:

Employees told they have

pre-diabetes or borderline

diabetes

= 7.5% - 5.6%

= 1.9%

A small absolute change but…

= (7.5% - 5.6%) = 1.9%

5.6% 5.6%

= 33.9%

A large relative change

Example 2:

Employees who participated

in some physical activities or

exercises…in the past month

= 87.9% - 83.9%

= 4.1%

A larger absolute change than in

example 1 but…

= (87.9% - 83.9%) = 4.1%

83.9% 83.9%

= 4.9%

A much smaller relative change

Significance of Differences Statistical significance evaluated at

α=o.05 using Chi-square testing

Practical significance if >+/-10%

relative change


3 COMPARATIVE RESULTS

The IUSE comparisons between 2015 and 2013 IU Workplace Health & Wellness Survey results are presented in this section, primarily in the form of

tables. Each section focuses on a content area, proceeding from left to right along the continuum of change.

In comparing the survey measures comprehensively, we color-coded our interpretations based on the combination of statistical and practical

significance. The color-coding is intended to provide a quick visual impression of the strength and degree of change observed in each content area.

Improvement is statistically and practically significant

Worsening is statistically and practically significant

Change lacks statistical and/or practical significance

Also, the tables reflect whether or not there were interventions being implemented at IUSE that focused on that aspect of workplace health in the two-

year period. Such interventions were provided by a variety of groups, and information regarding these interventions was provided to the survey team by

Healthy IU. Emblems distinguish between two levels of intervention:

Face-to-face intervention provided Communication only provided

Organizational Support

Resources & Programs

Lifestyle

Preventive Health Care

Stress

Health & Illness


3.1 ORGANIZATIONAL SUPPORT

*Statistically significant; NA = not asked/not comparably asked in given year

The content area of Organizational Support showed statistically and practically significant improvements in eight measures (green). The greatest

relative improvement (100.3% increase over 2013) was in the percentage of employees who say that IU has provided them with the opportunity to be

physically active. Another large improvement (relative change of 74.5%) was observed in the proportion of employees reporting having the opportunity

to manage their stress. Levels of stress reported by employees in the initial 2013 survey were a top concern, and subsequent efforts were focused on

improving this area of wellness. No measures exhibited a significant worsening. Two remained stable over the time period: job satisfaction and the

opportunity to live tobacco free.

2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Q10. Overall, how supportive is IU of your personal health? (Percent rating 7-10 on scale of 1-10) 62.5% 80.8% 18.3% 29.3% <0.001*

Q9. Overall, how safe do you think your workplace is? (Percent rating 7-10 on scale of 1-10) 79.6% 90.7% 11.1% 13.9% <0.001*

Q20. All in all, how satisfied would you say you are with your job? (Percent satisfied/very

satisfied) 85.0% 88.6% 3.6% 4.2% 0.074

Q11. Employees who Agree or Strongly Agree…

The people you work with take a personal interest in you. NA 78.5%

In your workplace, your co-workers support your efforts to be healthy. 64.1% 71.3% 7.2% 11.2% 0.011*

Your supervisor is concerned about the welfare of those under him or her. NA 70.9%

In your workplace, management considers workplace health and safety to be important. 54.0% 65.1% 11.1% 20.6% <0.001*

IU has provided you with the opportunity to be physically active. 33.9% 67.9% 34.0% 100.3% <0.001*

IU has provided you with the opportunity to eat a healthy diet. 38.2% 53.0% 14.8% 38.7% <0.001*

IU has provided you with the opportunity to live tobacco free. 89.3% 91.3% 2.0% 2.2% 0.278

IU has provided you with the opportunity to manage your stress. 26.7% 46.6% 19.9% 74.5% <0.001*

IU has provided you with the opportunity to work safely. 63.1% 80.2% 17.1% 27.1% <0.001*

TABLE 1. ORGANIZATIONAL SUPPORT

COMPARISON


3.2 RESOURCES & PROGRAMS

*Statistically significant; NA = not asked/not comparably asked in given year; / = insufficient sample size for analysis

Improving employee awareness and access to health-supporting Resources & Programs at their IU workplace was identified in 2013 as an opportunity for

rapid change and organizational action. The numerous intervention emblems shown in the final column of this table reflect the broad action taken in this

2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Access to clean drinkable water NA 89.8%

Opportunities to buy fresh fruits and vegetables 56.7% 63.7% 7.0% 12.3% 0.019*

Healthy food options in vending machines 20.6% 39.4% 18.8% 91.3% <0.001*

Healthy food options to purchase in the cafeteria or other food service 75.5% 80.4% 4.9% 6.5% 0.054

1-on-1 nutritional counseling NA 47.9%

Stress management or stress reduction classes/programs 16.8% 53.6% 36.8% 219.0% <0.001*A convenient place to work out or exercise (2015) - A place to work out or exercise such

as an onsite exercise room (2013)† 63.1% 48.0% -15.1% -23.9% <0.001*

A place to bike or walk 75.4% 88.5% 13.1% 17.4% <0.001*

A walking program 1.9% 67.8% 65.9% 3468.4% <0.001*

Ergonomics (work station or computer setup, proper lifting, etc.) 30.2% 29.3% -0.9% -3.0% 0.771

Flu shots at work 94.4% 88.0% -6.4% -6.8% <0.001*

Employee Assistance Program (access to professional counseling) 74.8% 79.3% 4.5% 6.0% 0.090

Programs to help people stop smoking (of current smokers) / /

Healthy weight/weight loss programs 27.9% 52.2% 24.3% 87.1% <0.001*

Blood pressure monitoring device available for self assessment 4.1% 79.0% 74.9% 1826.8% <0.001*

A true smoke-free workplace 86.9% 77.0% -9.9% -11.4% <0.001*

A private area/lactation room for moms who are breast-feeding (of women aged 18-44) 8.8% 42.1% 33.3% 378.4% <0.001*

Signs that encourage stair use 10.6% 17.9% 7.3% 68.9% 0.001*

Markers that identify walking trails NA 22.5%

Easy to access maps of walking trails NA 42.2%

A designated person who communicates health and wellness information to your work

group NA 35.7%

TABLE 2. Q12: Are the following PROGRAMS OR RESOURCES currently available at your

workplace? (Percent who said yes)

COMPARISON


area. Healthy change is clearly evidenced in the broad improvements seen in 9 of the measures – improvements that are both statistically and practically

significant. In fact, relative increases of 0ver 1000% were measured for walking programs (relative change of 3468.4%) and blood pressure self-

monitoring devices (relative change of 1826.8%). Increases over 100% were reported for private lactation areas (378.4%) and stress management

programs (219.0%). Two measures did exhibit a worsening over the time period. A smaller proportion of employees reported having a convenient place

to exercise (relative change of -23.9%). Additionally, the percentage of employees with access to “a true smoke-free workplace” significantly worsened

(by 11.4% relative to 2013). The remaining 4 measures were stable over the 2-year period.

3.3 LIFESTYLE

*Statistically significant; NA = not asked/not comparably asked in given year; / = insufficient sample size for analysis

The content area of Lifestyle Influences on Health moves us toward the middle of the continuum of change. One of the changes in lifestyle measures—

employees meeting aerobic physical activity guidelines—met our criteria for being both statistically and practically significant for improvement.

2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Q22. Employees getting enough restful sleep to function well in job and

personal life - always/most of the time 61.4% 61.0% -0.4% -0.7% 0.908

Q64 & Q65. Employees whose BMI falls within normal range (18.5-24.9) 37.0% 28.8% -8.2% -22.2% 0.006*

Q23. Employees who do not smoke cigarettes 96.8% 98.0% 1.2% 1.2% 0.216

Q24. Current smokers who stopped smoking for one day or longer because

they were trying to quit / /

Q25. Employees who participated in some physical activities or

exercises…during the past month 88.4% 95.6% 7.2% 8.1% <0.001*

Q26 and 27. Employees meeting the aerobic physical activity guidelines 60.0% 70.1% 10.1% 16.8% 0.001*

Q28. Employees meeting the strength-training guidelines 52.0% 55.2% 3.2% 6.2% 0.247

Q26-28. Employees meeting both aerobic and strength-training guidelines 43.0% 47.6% 4.6% 10.7% 0.124

Q33. (Of those who mostly sit on the job) Employees who are able to get up

and move around 8 or more times during a usual 8 hour work day 50.4% 46.2% -4.2% -8.3% 0.337Q18. Employees who Always/Usually get the social and emotional support they

need 65.6% 61.0% -4.6% -7.0% 0.420

TABLE 3. LIFESTYLE INFLUENCES ON HEALTH

COMPARISON


Another—proportion of employees reporting a BMI within the normal range—met our criteria for significant worsening. The remaining measures were

stable and did not exhibit either statistical or practical significance in their changes.

3.4 PREVENTIVE HEALTH CARE


Most 2015 Preventive Health Care survey measures were overall stable and consistent with 2013 measures. Given the excellent baseline rates reported

by IUSE employees for routine checkups, blood pressure checks, and cholesterol testing, there is little room for improvement in this area. However,

significant worsening did occur with the proportion of employees having their blood sugar tested in the past 3 years. Additionally, consistent with 2013,

there remains room for improvement in the percentage of employees who receive a seasonal flu vaccine.

2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Q34. Employees who visited a doctor for a routine checkup within the past 2

years 91.5% 87.6% -3.9% -4.3% 0.039*Q35. Employees who had blood pressure checked by a health professional

within the past year 97.8% 95.0% -2.8% -2.9% 0.018*

Q36. Employees who last had a cholesterol test less than 5 years ago 98.1% 94.9% -3.2% -3.3% 0.006*

Q37. Employees who had a lab test for high blood sugar or diabetes within the

past 3 years 88.1% 75.0% -13.1% -14.9% <0.001*

Q38. Employees who had a seasonal flu vaccine during the past 12 months 56.2% 52.8% -3.4% -6.0% 0.272

TABLE 4. PREVENTIVE HEALTH CARE

COMPARISON


3.5 STRESS


Measures of the impact of stress persisted from 2013 to 2015 with little change overall. In 2015, we added two new measures to help us better

understand the interplay of stress between home and work. Based on these results, work stress affects employees at home more often than home stress

affects employees at work. Despite greater reported access to opportunities to manage stress (as reported in Table 3.1), we do not yet see a reduction in

the impact of that stress on employees’ health.

2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Q21. Employees who said stress (from all sources at work or at home) had a lot

or some impact on their health in the past year 73.5% 70.5% -3.0% -4.1% 0.288

Q19. Employees who responded Always/Often

How often do you find your work stressful? 48.6% 44.7% -3.9% -8.0% 0.225How often do things going on at work make you tense or irritable at home? NA 67.6%

How often do things going on at home make you tense or irritable at work? NA 9.2%

How often in past month have you felt used up at the end of the day? 50.2% 50.2% 0.0% 0.0% 0.997

TABLE 5. IMPACT OF STRESS

COMPARISON


3.6 HEALTH & ILLNESS


2013 2015Absolute

Change

Relative

Changep-value

Change

Code

Intervention

Provided

Q14. Employees rating their health as fair or poor 9.8% 10.7% 0.9% 9.2% 0.638

Q15. Employees with one or more days of poor physical health in past 30 38.7% 32.7% -6.0% -15.5% 0.043*

Q16. Employees with one or more days of poor mental health in past 30 42.4% 35.0% -7.4% -17.5% 0.020*

Q17. Employees with one or more days in past 30 when poor physical/mental

health interfered with usual activities 32.8% 27.6% -5.2% -15.9% 0.068[Employees responding yes - Have you EVER been told by a doctor, nurse, or

other health professional that you have…]

Q39. High blood pressure 22.3% 19.7% -2.6% -11.7% 0.288

Q39. Borderline high or pre-hypertensive 16.4% 23.8% 7.4% 45.1% 0.004*

Q42. High blood cholesterol 40.0% 41.9% 1.9% 4.7% 0.555

Q45. Diabetes 5.1% 4.5% -0.6% -11.8% 0.638

Q45. Pre-diabetes or borderline diabetes 5.7% 10.5% 4.8% 84.2% 0.007*

Q48. Asthma - ever 11.5% 16.0% 4.5% 39.1% 0.041*

Q49. Asthma - among those ever diagnosed, those who currently have asthma NA 67.0%

Q51. Arthritis 24.7% 32.4% 7.7% 31.2% 0.006*

Q53. Arthritis-related activity limitations 17.4% 36.7% 19.3% 110.9% 0.001*

Q57. Depressive disorder 26.1% 24.9% -1.2% -4.6% 0.624

Q60. Heart disease 1.8% 1.3% -0.5% -27.8% 0.552

Q61. Carpal tunnel syndrome 13.5% 10.5% -3.0% -22.2% 0.136

[Employees who self-identified having ...]

Q54. Chronic or recurrent low back pain 30.6% 39.4% 8.8% 28.8% 0.003*

Q64 and Q65. Obesity (calculated BMI ≥30.0) 29.0% 30.8% 1.8% 6.2% 0.554

Q64 and Q65. Overweight (calculated BMI 25.0-29.9) 33.0% 40.3% 7.3% 22.1% 0.019*Q62. Health problems they think may be due to physical surroundings at

workplace NA 19.2%

TABLE 6. HEALTH & ILLNESS

COMPARISON


The final content area, to the far right of the continuum of change, describes the Health & Illness measures of IUSE employees. Significant improvements

were observed in the proportion of employees reporting poor physical or mental health over the past month. Several areas showed a worsening of

conditions. However, in this content area, the color-coded changes cannot be interpreted in the same straightforward manner as in previous sections.

Some of the measures coded red (for significant increases) may, in fact, be positive and health-promoting. For example, an increase in those diagnosed

with borderline high or pre-hypertension as well as pre-diabetes or borderline diabetes may mean that employees are being screened and made aware of

their risk at an earlier point where prevention of full disease is possible. Significant increases in the proportion of employees ever diagnosed with asthma,

arthritis, arthritis-related activity limitations, and chronic back pain were reported. An increase in the percentage of employees considered to be

overweight was also observed, and weight management remains a priority area for future improvement. Of note, most of these conditions develop over

a period of years. A leveling-off of disease rates is considered success through fewer new diagnoses among employees, as it is essentially impossible for

employees who have once been diagnosed with a condition to be “un-diagnosed.” Stabilization of these rates is a long-term aim.

4 CONCLUSIONS

What does this comparison of the 2013 and 2015 survey results tell us?

Statistical and practical significance, as well as consistency between 2013 and 2015, give us confidence that observed changes (for better or

worse) are real changes in the IUSE community.

Clear improvements are seen particularly – and as anticipated – in those content areas to the left of the continuum of change.

We held our ground in some longer-term outcomes, but worsened in others during the 2-year period. The most challenging outcomes, especially

disease rates, take longer to show improvement, as chronic diseases typically develop over a period of years, and once an employee is diagnosed,

they cannot revert back to the undiagnosed group. Holding ground in long-term outcomes such as disease rates is, therefore, success.

We still have work to do, but we are moving in the right direction.


A team within the IU Richard M. Fairbanks School of Public Health at IUPUI designs, conducts, and analyzes the IU Workplace Health & Wellness

Survey on behalf of the multi-campus IU community. We are a team committed to employee confidentiality and quality data that drive healthy change.

Any questions? Contact us at [email protected]

Co-Principal Investigators: Gregory K. Steele, DrPH, MPH

Lisa K. Staten, Ph.D

Project Manager: Tess D. Weathers, MPH

Data Analyst: Jennifer Alyea, MPH and Doctoral Student

Suggested Citation:

IU Fairbanks School of Public Health Survey Team. (2016). Gauging Progress toward a Healthier IU: A Comparison of the IU Workplace Health and Wellness

Survey Results from 2013 and 2015. (Series of 8 reports focusing on each IU campus location.) Available at:

https://pbhealth.iupui.edu/index.php/research/bhealthy/2015-results/

mailto:[email protected]

https://pbhealth.iupui.edu/index.php/research/bhealthy/2015-results/

Documents

Gauging Progress toward a Healthier IU: Focus on IU Southeast · A total of 146 IUSE employees responded to our survey, yielding a 32.7% response rate. Quantitative data were analyzed